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Policy Details

Contact Information

1-800-265-8098 ext. 828

ontario@palcanada.com

Are you a Broker or Agent?

Yes

Section 1

Reference #

21-193018

Select Policy Document Language: *

Province: *

Search by Event Location or Name of Venue: *

Name of location of event: *

Address of location: *

City: *

Postal Code: *

Location Type: *

Limit of liability required: *

Tenants legal liability limit required: *

Is this a private residence, house, farm or field?: *

Yes No

Section 2

Name of insured: *

If individual, date of birth:

Address: *

City: *

Province: *

Postal Code: *

Phone Number: *

Email: *

Additional Insured: *

Yes No

Section 3

Add Additional Insured: If an additional insured is required to be named, please describe the additional insured relationship to the event. Select if the additional insured is the Event Venue or Event City/Municipality and provide their name and address. Then select the ADD ADDITIONAL INSURED. You may add more additional insureds by repeating these steps.

Type: *

Venue Owner/Event Location
City/Municipality

Name Of Additional Insured: *

Address:

City:

Province:

Postal Code:

Section 4

Is this an event with sports or athletic activities?: *

Yes No

Is this a sport tournament?:

Can you confirm first aid supplies/ first aid services are readily available on site?:

Yes No

Is this a professional sport/athletic event?:

Yes No

Is coverage required for injury to participants in sporting events arising out of the negligence of the event host / organizer?:

Yes No

Is the applicant participating in, managing, or organizing any of the following: sports club and/or league, sporting association, or sporting tournament?:

Yes No

Are Waivers signed by all participants?:

Yes No

Is the event a virtual event?:

Yes No

If yes, does the VIRTUAL portion of your event involve sporting/athletic activities or alcohol service/consumption.:

Yes No

Will there be alcohol service/consumption at any of the activities excluding Virtual portion?:

Yes No

Event Type: *

Additional Event Details, If Applicable:

Event Effective Date: *

Start Time: *

Event Expiry Date: *

End Time: *

Max # of attendees (per day): *

Max # of attendees (whole event): *

Admission Fee ($): *

Section 5

Will there be entertainment at the event?: *

No
Playlist – ipod radio laptop
D.J.
Live entertainment

Entertainment Performer:

Entertainment Type:

Professional Amateur

Is coverage required for injury, arising from your negligence, to the performers/entertainers at your event?:

Yes No

Entertainment Genre:

Will there be vendors or exhibitors at the event: *

Yes No

Is proof of insurance a requirement for the vendors/exhibitors to set-up at the event:

Yes No

Will food and beverages be served at the event: *

Yes No

Who is providing food and / or beverages?:

Section 6

CANNABIS EVENT LIABILITY

ATTENTION: Event Attendees may bring their own legally sourced Cannabis to this event! AND, you as an event organizer MAY NOT BE AWARE of this heightened exposure.

There will be an automatic “Cannabis Event Liability” Extension option that will pre-populate with your quotation if you would like to purchase this Cannabis Coverage extension AS AN ADD ON.

Please complete below for all other Cannabis Exposure.

Will there be cannabis consumed at the event / on the event premises?: *
Yes      No

Will any cannabis (or variety of cannabis) be supplied by the applicant/host of the event?:
Yes      No

All Cannabis smoking/vaping MUST take place outdoors check YES to confirm:
Yes

Will any cannabis (or variety of cannabis) be supplied by a third party vendor?:
Yes
No

Will the third party vendor carry their own cannabis liability at a minimum of $2 million dollars?:
Yes      No

Have all permits and licenses etc been approved and granted from the government or municipality or regulators?:
Yes      No

Will there be a legally licensed Cannabis designated area outdoors?:
Yes      No

How many people in the designated area?:

Will ID checks be in place for cannabis area?:
Yes      No

Will there be security personnel in place with their own insurance coverage for their operations?:
Yes      No

Section 7

Will there be alcohol served/consumed at any of the activities: *
Yes      No

How many days of alcohol coverage do you require?:

Section 8

Who is in charge of the service of alcohol:

All Rules and Regulations pertaining to the service and/or consumption of alcohol must be abided.

Activity #1 where alcohol will be served/ consumed

Date:

From:

To:

Location:

# of patrons:

Are servers trained:
Yes      No

Activity #2 where alcohol will be served/ consumed

Date:

From:

To:

Location:

# of patrons:

Are servers trained:
Yes      No

Activity #3 where alcohol will be served/ consumed

Date:

From:

To:

Location:

# of patrons:

Are servers trained:
Yes      No

Activity #4 where alcohol will be served/ consumed

Date:

From:

To:

Location:

# of patrons:

Are servers trained:
Yes      No

If alcohol is served/ consumed at additional activities, please insert information in comment box below.

Additional details/ activities:

Section 9

Will fireworks/ special effects or petting zoos/ other animals be involved in the event. If yes, a certificate of insurance or further underwriting may be required.: *

Will there be a parade: *
Yes      No

If yes, please specify the number of units in the parade:

Length of Parade:

Police Escort:
Yes      No

Are there any horses:
Yes      No

If YES to horses, please confirm if each horse owner is required to provide proof of insurance prior to the parade.:
Yes      No

Is the applicant providing any overnight camping or other accommodation: *
Yes      No

Accommodation type:

Other - please specify:

If event involves youth, please provide sleeping arrangement details:

Will there be any inflatables/ jumping castle: *
Yes      No

Details:

If yes, is coverage secured elsewhere?:
Yes      No

If no coverage is in place elsewhere, an extension with a sublimit of $250,000.00 is available to be added to the policy, subject to additional premium of $50.00.

Do you want coverage? (some restrictions may apply):
Yes      No

Will any temporary grandstands, bleachers or stages be set-up: *
Yes      No

If yes, Who will do the installation:

Will a certificate of insurance be provided by the installers:
Yes      No

Please provide details on the installation:

Who will be providing security at the event: *

How many people on site for security/ supervision:

Will there be any designated children areas (ie: babysitting): *
Yes      No

If yes, please provide pick-up / identification procedures:

Has the event been held in the past: *
Yes      No

Have you been declined or cancelled by any other insurer(s).: *
Yes      No

If so, please provide details:

Previous Insurer and premium paid:

Have you had any claims / loss history?: *
Yes      No

Loss History:

Do you have any special request for coverage:

Do you require property coverage for items you own or rent?:

Property covered, other amount:

Please describe the property to be covered?:

General comments:

You may wish to attach any photos, posters, brochures, diagrams, or any additional information that would be may be useful for underwriting purposes.

Attachment:

Attachment #2:

Section 10

Name of person completing this form: *

Mailing Address of person completing form: *

City: *

Province: *

Postal Code: *

Phone Number: *

Email: *

Verify Email: *

I /We hereby declare that the answers and declarations above, whether in my own hand or not, are true and that I /we warrant that no material fact has been withheld or misstated and agree that this proposal will form part of the policy and will form the basis of the contract with underwriters. I /we understand that the underwriters may declare any policy issued void in the event of any false statement, misrepresentation, omission or concealment whether made intentionally, innocently or accidentally. For purposes of the Insurance Companies Act (Canada), this document was issued in the course of Lloyd's Underwriters' insurance business in Canada

I/we agree: *
Yes

I have reviewed the information above and have ensured it is 100% accurate. I have also included any Additional Insureds that may be required within the Venue’s rental agreement/requirements.

Check to confirm: *
Yes

How did you hear about us?:

If other, please specify:

Please note that this is an application only. It does not constitute an insurance policy. Insurance shall become effective only on issuance of a policy or written binder specifically authorized by the company or agency. Quotations will be based upon the information provided and applicant warrants information provided.

HELPFUL INFORMATION

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Check the screen for any error messages. They will appear in red above the location of the error.

Double check your information to make sure it has been entered correctly.

You can always start over from scratch if you are having issues.

You may want to try a different browser. Sometimes the settings of a certain browser may cause a problem and using a different browser will allow you to complete your submission.

CUSTOMER SERVICE

E-mail: ontario@palcanada.com

Phone: 1-800-265-8098 ext. 828

Hours: Ontario 8:30am to 4:30pm EST Alberta 8:30am to 4:30pm MST

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Contact Information

Are you a Broker or Agent?

Section 1

Section 2

Section 3

Section 4

Section 5

Section 6

CANNABIS EVENT LIABILITY

Section 7

Section 8

If alcohol is served/ consumed at additional activities, please insert information in comment box below.

Section 9

Section 10

HELPFUL INFORMATION

CUSTOMER SERVICE

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PAL is a Proud Member of

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Contact Information

Are you a Broker or Agent?

Section 1

Section 2

Section 3

Section 4

Section 5

Section 6

**CANNABIS EVENT LIABILITY**

Section 7

Section 8

If alcohol is served/ consumed at additional activities, please insert information in comment box below.

Section 9

Section 10

HELPFUL INFORMATION

CUSTOMER SERVICE

Start Over!

Noteworthy News Items

PAL’s Weddinguard Insurance could have helped when many weddings were displaced after devastating floods

Panicked brides-to-be had to search for their gowns after Toronto bridal store shuts down

Brides left in the lurch after Guelph DJ closes up shop without warning.

PAL is a Proud Member of

Calgary, AB

Simcoe, ON

Montreal, QC

CANNABIS EVENT LIABILITY